Next Generation is a Brigham Clinical & Research News column penned by students, residents, fellows and postdocs. If you are a Brigham trainee interested in contributing a column, email us. This month’s column is written by Zahra Aryan, MD, MPH, a research fellow under the mentorship of Calum MacRae MD, PhD, the Division of Cardiovascular Medicine.
As I prepared to start my postdoctoral training at the Brigham, I was excited for this new opportunity but also filled with uncertainty. Leaving my home country to build a career in medicine in the U.S. was not easy. I left my home country, Iran, two years ago. I faced several challenges, including, but not limited to, visa processing, finances, and other restricted regulations based on the country in which I was born. Getting to know my new job duties and impressing my new supervisors — world-renowned leaders in cardiovascular medicine — was stressful enough. But this was also a time of profound political tension between the U.S. and Iran. Would I be accepted by my colleagues and patients? Moreover, could I do my job well and, as a non-native English speaker, communicate effectively?
First Steps Look Harder Than They Are
Soon after I arrived and started my job, my questions were answered. The Brigham community was welcoming, and the first sign that I had made the right decision occurred at the bedside.
As part of the “Driving Genomics” research project exploring the impact of incorporating genome sequencing into clinical practice I had to act as data wrangler, gathering deep phenotype data including a detailed family history and pedigree (family tree) of participants to interpret their genomic data. The first step was to sit with patients and families and capture their complete medical history and family history. Sequencing can be anxiety provoking for some people due to fear of incidental findings or insurance discrimination so I had to prepare myself to address their concerns. Having this conversation would require building a rapport with people, and I was nervous that, as an international scholar, I wouldn’t be able to do it.
One of my first interviews was with a middle-aged man who had suffered a heart attack and was recovering in his bed, surrounded by his wife and parents. The patient and his family agreed to participate to determine whether any genetics were underlying the heart attack as well as to understand any secondary findings. I sat with them, drew their family pedigree and gathered a thorough family history, which is not currently part of the electronic health record of hospitalized patients. This took close to one hour, and it ended up being one of the most pleasant history-takings of my career because it turned into an interactive history taking. This kind participant was interested to look at his family pedigree and review it and hear back his genetic results.
Once the rapid turnaround whole-genome sequencing data was ready, I started curating about 5 million genetic variants. It turned out that the patient was a carrier for genetic diseases that had a cost-effective way to be treated. We returned the results, and I felt happy to be brave enough to take that first step to serve as junior physician scientist.
Diverse Community, Diverse Staff, Diverse Patients
The next moment that reinforced I had made the right decision to come here also occurred at the bedside, although in an entirely different context.
One morning, I came to interview another patient who had experienced a heart attack, but that day was different. The patient was clearly anxious about his illness and eager to discover any genetic component underlying his current admission. After I introduced myself, he asked me, “Are you Persian?” I responded that I was. He said, “Can we continue the interview in Farsi?” I told him that of course we could. (Farsi, the Persian language, is predominantly spoken in Afghanistan, Iran and Tajikistan.) It turned out that he was an immigrant, and being able to speak with me about his medical history in his mother tongue made him feel more comfortable. At the end of day, I reflected on how beautiful it is to work in such a diverse environment.
At the Brigham, I found a welcoming environment where not only staff but also patients can find support whenever needed. Mentors who provide reassuring guidance while leading cutting-edge projects, friendly colleagues who are open to assist you in performing your daily tasks well, employee assistance programs, communications-related events happening in the hospital — all gave me the sense that I’m part of the big Brigham family, and turned all of my uncertainties at the beginning into confidence at the end.
The inclusive and diverse community here has helped me build my career, and gain invaluable experience, while enjoying very pleasant moments in the hospital (like the Nowruz, Persian New Year, celebration on the bridge of the Shapiro Building). This peaceful environment not only has given me great experiences, but also serves as a great resource for patients with diverse backgrounds and cultures. I wrote this column to share my postdoc experience and also to thank the Brigham community, for being not only a leader in medicine, but also inclusive and diverse.